Tamaki Masaharu, Wada Hidenori, Gomyo Ayumi, Hayakawa Jin, Akahoshi Yu, Harada Naonori, Kusuda Machiko, Ishihara Yuko, Kawamura Koji, Tanihara Aki, Sato Miki, Terasako-Saito Kiriko, Kameda Kazuaki, Kikuchi Misato, Kimura Shun-Ichi, Nakasone Hideki, Kako Shinichi, Kanda Yoshinobu
Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho Omiya-ku, Saitama, 330-8503, Japan.
Int J Hematol. 2018 Jan;107(1):117-121. doi: 10.1007/s12185-017-2296-z. Epub 2017 Jul 6.
Donor-derived malignancy is a rare morbidity after allogeneic hematopoietic stem cell transplantation (HSCT), in which most previous cases have presented as acute leukemia or myelodysplastic syndrome. There have, however, been very few reports of donor-derived lymphoma. Here, we present a case of donor-derived mantle cell lymphoma 12 years after allogeneic HSCT, which was successfully treated with chemotherapy followed by pseudo-autologous HSCT (pASCT), i.e., an autologous HSC transplant following allogeneic HSCT in which the infused stem cell is considered to be derived from the donor cells. Although pASCT carries the risk of graft-versus-host disease (GVHD) due to the reinfusion of donor-derived peripheral blood cells, the present case did not develop GVHD without prophylaxis. The current case and a small number of previous reports suggest that the duration between allogeneic HSCT and pASCT may be important to the induction of immune tolerance, but further study in a larger number of cases is needed.
供者来源的恶性肿瘤是异基因造血干细胞移植（HSCT）后一种罕见的并发症，此前大多数病例表现为急性白血病或骨髓增生异常综合征。然而，供者来源的淋巴瘤报告却非常少。在此，我们报告1例异基因HSCT后12年发生供者来源套细胞淋巴瘤的病例，该病例经化疗后成功接受了假性自体HSCT（pASCT）治疗，即异基因HSCT后进行的自体造血干细胞移植，其中输注的干细胞被认为来源于供者细胞。尽管pASCT由于回输供者来源的外周血细胞而有发生移植物抗宿主病（GVHD）的风险，但本病例在未进行预防的情况下并未发生GVHD。本病例及少数既往报告提示，异基因HSCT与pASCT之间的间隔时间可能对免疫耐受的诱导很重要，但需要对更多病例进行进一步研究。
